Title: Impact of Metronomic Chemotherapy on Quality of Life in Recurrent, Residual and Metastatic Head & Neck Cancers

Authors: Shilpa Kandipalli, Santhosh. V, Praveena Voonna

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.11

Abstract

Background: Quality of life is significantly affected in both radically treated as well as palliative care patients of Head & Neck cancers. Both Surgery as well as Radiation with concurrent chemotherapy affect quality of life with long lasting disabilities. Hence the present study was done to evaluate the role of Metronomic Chemotherapy on Quality of life in Residual, Recurrent and Metastatic Head & Neck cancers.

Methods: All patients who met the inclusion criteria in our study were treated with Oral Metronomic Chemotherapy with Methotrexate and Capecitabine. Quality of Life assessment was done at month 0, month 3 and month 6.

Results: The predominant problematic domains identified by QOL H&N-35 scale were pain, difficulty in swallowing, dry mouth, mouth opening, sticky saliva, social eating, social contact and less sexuality. There is a significant improvement in QOL of most of the survivors in the present study at the end of 6 months. But there was no significance as far as illness, senses, coughing, feeding tube and weight gain are concerned

Conclusion:  Oral Metronomic Chemotherapy with Methotrexate and Capecitabine significantly improves the Quality of life in patients with Residual, Recurrent and Metastatic Head & Neck cancers.

Keywords: Metronomic Chemotherapy, Quality of Life, Head & Neck cancers.

References

  1. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2017; 3:524.
  2. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001;94:153-6
  3. Farquhar M (1995)Definitions of quality of life: A taxonomy. Journal of Advance Nursing 22: 502-508
  4. World Health Organization (1994)The WHO Health Promotion Glossary 1998. World Health Organization, Geneva, Switzerland
  5. Morton RP, Izzard ME (2003)Quality-of-life outcomes in head and neck cancer patients. World J Surg 27: 884-889.
  6. Kazi R, Cordova J (2007)Quality of life following total laryngectomy: Assessment using the UW-QOL scales. ORL J Otorhinolaryngology Relat Spec 69: 100-106
  7. Rekha, M. Vishnu Vardhan Reddy, P. Pardhananda Reddy. Epidemiological Studies of Head and Neck Cancer in South Indian Population. Journal of Research In Cancer and Tumor 2013, 2(2): 38-44
  8. Palan et al, Assessment of quality of life in radically treated head and neck cancer patients: A cross-sectional study in a tertiary care setting-Journal of Onco Immunology-1000105.
  9. Stephen Wan Leung, Tsair-Fwu Lee et al, health-related quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires; BMC Cancer 2011, 11:128
  10. Prima J Jyothi, Jyothi Chakrabarthy et al, Quality of Life of Head and Neck Cancer Patients Receiving Cancer Specific Treatments; JKIMSU, Vol.2, No.1, Jan-June 2013.
  11. Mross K, Steinbild S et al. Metronomic anti-cancer therapy-an Ongoing treatment option for advanced Cancer patients. Journal of Cancer Therapeutics and Research;2012. ISSN 2049-7962
  12. Colevas AD. Chemotherapy options for patients with metastatic or recurrent squamous cell carcinoma of the head and neck. J ClinOncol 2006;24:2644-52.
  13. Martinez-Trufero J, Isla D, Adansa JC, Irigoyen A, Hitt R, Gil-Arnaiz I, et al. Phase II study of capecitabine as palliative treatment for patients with squamous head and neck cancer with locoregional and/or metastatic relapse after previous platinum-based treatment: Final results of Spanish Head and Neck Cancer Group. J ClinOncol 2009;27 15 Suppl: 312s.
  14. Mateen A, Adil AR, Maken RN, Khan SA, Arif M. Metrnomic Chemotherapy in recurrent head and neck cancer. J Clin Oncol.2015;33suppl:abstr e 17007.
  15. Patil V, Noronha V, Krishna V, Joshi A, Prabhash K. Oral metronomic chemotherapy in recurrent,metastatic and locally advanced head and neck cancers. ClinOnco (R CollRadiol)2013;25:388.

Corresponding Author

Shilpa Kandipalli

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